Individual
DR. EDWARD KENNETH MCGOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
655 W 8TH ST, JACKSONVILLE, FL 32209-6511
(904) 244-5431
Mailing address
PO BOX 44008, JACKSONVILLE, FL 32231-4008
(904) 244-5431
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
50410
FL
207L00000X
Anesthesiology Physician
Primary
ME50410
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
374438800
—
FL
Enumeration date
09/08/2005
Last updated
05/22/2023
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